Department of Community Medicinehttp://ir.lib.ruh.ac.lk/xmlui/handle/iruor/74072024-03-29T01:02:51Z2024-03-29T01:02:51ZRoad traffic crashes and built environment analysis of crash hotspots based on local police data in Galle, Sri LankaDe Silva, P. V.Tharindra, HemajithVissoci, J. R. N.Andrade, LucianoMallawaarachchi, B. C.Ostbye, TrulsStaton, Catherine A.http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/146952023-09-18T07:08:03Z2018-09-01T00:00:00ZRoad traffic crashes and built environment analysis of crash hotspots based on local police data in Galle, Sri Lanka
De Silva, P. V.; Tharindra, Hemajith; Vissoci, J. R. N.; Andrade, Luciano; Mallawaarachchi, B. C.; Ostbye, Truls; Staton, Catherine A.
Road traffic crashes (RTCs) are a leading cause of death and disability. In low- and middle-income countries, vulnerable road users are commonly involved in injurious RTCs. This study describes epidemiological and built environment analysis (BEA) of in Galle, Sri Lanka. After ethical and police permission, police data were collected and descriptive statistics tabulated. Spatial analysis identified hot spots and BEA was conducted at each location. Seven hundred and fifty-two victim data from 389 reported RTCs were collected. Most victims were male (91%) 21-50 years of age (>70%). Forty-nine percent of RTCs were non-grievous. Crashes commonly included motorcycles (33.9%), three-wheelers (18.3%) or cars (14.4%). Most victims were drivers (33.4%) or pedestrians (21.3%). Factors contributing to RTCs include aggressive driving (44.5%) or speeding (42.7%). All hotspots were in urban areas, and most were at intersections (63%). Further analysis of hot spots is necessary to identify areas for intervention.
2018-09-01T00:00:00ZPredictors of ambulance transport to first health facility among injured patients in southern Sri LankaReynolds, Lindy M.De Silva, P. V.Clancy, ShaynaJoiner, AnjniStaton, Catherine A.Østbye, Trulshttp://ir.lib.ruh.ac.lk/xmlui/handle/iruor/146912023-09-18T06:58:05Z2021-06-25T00:00:00ZPredictors of ambulance transport to first health facility among injured patients in southern Sri Lanka
Reynolds, Lindy M.; De Silva, P. V.; Clancy, Shayna; Joiner, Anjni; Staton, Catherine A.; Østbye, Truls
Background
Injuries account for about 13% of all registered deaths in Sri Lanka and are the leading cause of admission to public hospitals. Prehospital trauma care is new to Sri Lanka, and in 2016, a free ambulance service was launched in the Western and Southern provinces.
Objective
The aim of this study was to identify the proportion of admitted injury patients at a tertiary hospital who used an ambulance to get to the first health facility and examine patient demographics, injury event, and injury type as predictors of ambulance transport.
Methods
A cross-sectional survey was administered to 405 patients who were admitted to the emergency trauma center at Teaching Hospital Karapitiya (THK) in Galle, Sri Lanka. Descriptive statistics were tabulated to summarize prehospital transportation variables. Logistic regression models were created to examine predictors of ambulance transport, and ArcGIS Pro was used to calculate the distance between injury location and first facility and THK.
Results
The proportion of patients with injuries who used an ambulance to get to the first health facility was 20.5%. Factors that were significantly associated with ambulance use were older age, injury mechanism, alcohol use prior to injury, location type, open wound, abrasion, and chest/abdomen injury. Distance from injury location to THK or nearest health facility were not significantly associated with ambulance transport to the first health facility.
Conclusion
Among lower acuity injury patients in southern Sri Lanka, 20.5% traveled in an ambulance to the first health facility, while over half used a tuk tuk. Older age and injuries at home were associated with lower odds of ambulance transport. Future studies on predictors of ambulance transport should include patients with more severe injuries, gather detailed data on care provided while in transport and examine the association between prehospital care and clinical outcomes.
2021-06-25T00:00:00ZPredictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional studyWyatt, SageOstbye, TrulsDe Silva, P. V.Lakmali, PrabodhaLong, Qianhttp://ir.lib.ruh.ac.lk/xmlui/handle/iruor/146902023-09-18T06:47:16Z2021-11-10T00:00:00ZPredictors and occurrence of antenatal depressive symptoms in Galle, Sri Lanka: a mixed-methods cross-sectional study
Wyatt, Sage; Ostbye, Truls; De Silva, P. V.; Lakmali, Prabodha; Long, Qian
Background: There is a high prevalence of antenatal depression in low-or-middle-income countries, but information about risk factors in these settings is still lacking. The purpose of this study is to measure the prevalence of and explore risk factors associated with antenatal depressive symptoms in Galle, Sri Lanka.
Methods: This study used a mixed-method approach. The quantitative portion included 505 pregnant women from Galle, Sri Lanka, with health record data, responses to psychometric questionnaires (MSPSS and PRAQ-R2), and antenatal depression screening (EPDS). The qualitative portion included interviews with public health midwives about their experiences and routine clinical practices with women with antenatal depressive symptoms.
Results: Prevalence of antenatal depressive symptoms was 7.5%, highest in women over the age of 30 (13.0%, OR = 3.88, 95%CI = 1.71 - 9.97), with diabetes (21.9%, OR = 3.99, 95%CI = 1.50 - 9.56), or pre-eclampsia in a previous pregnancy (19.4%, OR = 3.32, 95%CI = 1.17 - 8.21). Lower prevalence was observed in the primiparous (3.3%, OR = 0.29, 95%CI = 0.12 - 0.64) employed outside the home (3.6%, OR = 0.33, 95%CI = 0.13 - 0.72), or upper-middle class (2.3%, OR = 0.17, 95%CI = 0.04 - 0.56). Anxiety levels were elevated in depressed women (OR = 1.13, 95%CI = 1.07 - 1.20), while perceived social support was lower (OR = 0.91, 95%CI = 0.89 - 0.93). After multivariable adjustment, only parity (OR = 0.20, 95%CI 0.05 - 0.74) and social support from a "special person" (OR = 0.94, 95%CI = 0.77 - 0.95) remained significantly associated with depressive symptoms. Qualitative findings also identified antenatal health problems and poor social support as risk factors for depressive symptoms. They also identified different contributing factors to poor mental health based on ethnicity, higher stress levels among women working outside the home, and misinformation about health conditions as a cause of poor mental health.
Conclusions: Prevalence of antenatal depressive symptoms in Galle is lower than the recorded prevalence in other regions of Sri Lanka. Risk factors for antenatal depressive symptoms were identified on biological, psychological, and social axes. These variables should be considered when developing future guidelines for mental health and obstetric treatment in this context.
2021-11-10T00:00:00ZMothers at risk of postpartum depression in Sri Lanka: A population-based study using a validated screening toolRøysted-Solås, ThereseHinderaker, Sven GudmundUbesekara, LasanthaDe Silva, P. V.http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/146892023-09-18T06:14:19Z2022-05-25T00:00:00ZMothers at risk of postpartum depression in Sri Lanka: A population-based study using a validated screening tool
Røysted-Solås, Therese; Hinderaker, Sven Gudmund; Ubesekara, Lasantha; De Silva, P. V.
Background
Postpartum depression is an important public health concern. The prevalence of postpartum depression is estimated to be 18% worldwide. The purpose of this study was to estimate the prevalence of mothers at risk of postpartum depression in Sri Lanka and to investigate its associated risk factors.
Methods
This was a cross-sectional study conducted among 975 mothers in Galle district, Sri Lanka. The prevalence of mothers at risk of postpartum depression was assessed using the Edinburgh Postpartum Depression scale (EPDS) which has been validated for screening for mothers at risk of postpartum depression in Sri Lanka with a cut-off score 9 or more. Prevalence was estimated using a cut-off 9 or more, 10 or more, 11 or more and 12 or more to assess the difference in prevalence using unvalidated cut-offs for screening. Data from routine records on pregnancy, delivery and postnatal care was collected to investigate possible predictors of EPDS score 9 or more (risk of postpartum depression). Univariate and multivariable logistic regressions were performed to identify risk factors for EPDS score 9 or more (risk of postpartum depression).
Results
The prevalence of mothers with EPDS score 9 or more was found to be 9.4% (95%CI: 7.8– 11.4); EPDS score 10 or more was 5.6% (95%CI: 4.4–7.3). EPDS score 9 or more (risk of postpartum depression) was associated with the following risk factors: Former history of mental illness (aOR 32.9, 95%CI: 7.9–136.2), high maternal age 30–39 (aOR 2.2, 95%CI: 1.3–3.8), BMI 25.0–29.9 (aOR 2.6, 95%CI: 1.5–4.5), hypertension (aOR 3.6, 95%CI: 1.2– 10.9) and newborn death (aOR 28.9, 95%CI: 4.5–185.1). One in five women reported thoughts of self-harm.
2022-05-25T00:00:00Z